Partners in Care: Nursing's Influence in an Emergency Medicine Residency Program

Emergency Medicine (EM) as a specialty has embraced the model of interprofessional care teams in clinical settings. In addition to clinical training, EM program directors are required to ensure that residents are integrated into interdisciplinary quality improvement programs during their training, as well as to collect data for milestones regarding team management and collaborative care of the ED patient.  The CLER environment has emphasized institutional focus on interdisciplinary training and feedback.  To achieve these aims, residency and nursing leadership partnered to develop an innovative, interprofessional approach to incorporating nursing presence into core areas within EM residency training. An interested member of the nursing leadership developed a liaison role between the nursing team and the residency program.  Opportunities for enhanced collaboration between the groups were identified and interventions were introduced in a step-wise fashion over the next 2 years.  Innovative methods were employed to build a collaborative mindset that would support trainees into their future practice. Intended to meet several objectives spanning multiple needs, these innovative methods have met with wide spread acceptance and positive reviews. Post interview surveys from applicants have frequently listed “nursing interviewers” as one of the things most liked about the day, and qualitative comments from nurse partner program surveys have been universally positive.  A total of 101 nursing staff generated 635 electronic evaluations over the 27 months the program has been active, many with detailed and constructive comments for the residents that have served as the impetus for remediation.  Nursing presence has been a constant at M&M since the development of a nursing champion, with active participation from both leadership and nursing staff involved in the case.   Overall, our multifaceted approach has improved interprofessional relationships in all areas and bolstered the level of clinical care our teams provide.  We believe that programs across Graduate Medical Education should find similar opportunities for inclusion of nursing staff to foster these outcomes.